Plasma Donor Registration

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Plasma Donor Registration

Am I a donor?
I should have tested positive for COVID-19.
I needed to have symptoms like breathing problem, cough, cold, fever, body ache.
I do not have any children (women only).
I do not have diabetes.
I do not have high blood pressure.
I am not over the age of 65.

* Indicates required question

Name *

Your answer

Email *

Your answer

Address *

Your answer

Phone Number *

Your answer

Have you been diagnosed with COVID 19?

Yes

No

Clear selection

Age *

Your answer

Gender

Male

Female

Prefer not to say

Clear selection

City

Your answer

Blood Group

A+

A-

B+

B-

O+

O-

AB+

AB-

Clear selection

Aadhar Card

Yes

No

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Date of Recovery

MM

/

DD

/

YYYY

Discharge Report from Hospital

Yes

No

Clear selection

COVID Negative Test Report

Yes

No

Clear selection

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